The value of magnetic resonance imaging in screening myeloma lesions of the lumbar spine

Tertti, Risto; Alanen, A.; Remes, Kari

doi:10.1111/j.1365-2141.1995.tb05363.x

Cited by 51 publications

(24 citation statements)

References 10 publications

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“…In clinical practice, most centers still examine patients by CR of the entire skeleton. Different studies demonstrated major limitations of such a radiological skeletal survey due to frequently false-negative findings [15][16][17][18]. Particularly in patients with reduced bone density and a suspicion of osteolytic lesions in an anatomically complex body region, an accurate diagnosis with CR is difficult, and the risk of false diagnoses is high.…”

Section: Discussionmentioning

confidence: 97%

Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma

et al. 2007

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This study compares the sensitivity of whole-body multidetector CT (MDCT) and conventional radiography (CR) in the staging of multiple myeloma (MM). Twenty-nine patients with MM underwent a staging examination both by MDCT and CR. CT examination was performed with a collimation of 64x0.6 mm, a tube potential of 100 kVp, an effective tube current-time product of 100 mAs and automatic dose modulation as low-dose protocol. Number, size and diagnostic confidence of osteolytic lesions were determined and compared. The effective dose of MDCT and CR was assessed. Using MDCT, the detection of osteolysis was increased seven-fold concerning the spine. Ninety-seven lesions in 18 patients were detected exclusively by MDCT. The detection rate concerning the spine, pelvic skeleton and thoracic cage was significantly higher (p< or =0.001), and diagnostic confidence was increased by MDCT (p<0.02) compared to CR. Therapy was changed after MDCT in 18.2% of the patients with a clinical suspicion of progressive disease. The estimated effective dose of MDCT (4.8 mSv) and CR (1.7 mSv) was comparable. In conclusion, MDCT has a significantly higher sensitivity and reliability in the detection of osteolysis than CR and can be recommended as standard imaging method in the staging of MM.

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Section: Discussionmentioning

confidence: 97%

Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma

et al. 2007

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“…Staebler et al reported that in 50 to 55% of patients with focal and diffuse MRI patterns of MM, the skeletal radiographs were negative [20]. Tertti et al showed that MRI of the lumbar spine was superior to plain radiography in 13/41 (32%) patients, although the authors suggested that plain films are the most suitable method for screening all bone areas in MM patients [10]. Lecouvet et al compared the imaging findings of conventional radiographs and MRI of thoraco-lumbar and pelvic bone marrow in 80 patients with stage III MM [21].…”

Section: Discussionmentioning

confidence: 95%

“…MRI has been shown to be more sensitive than the RSS in the detection of myelomatous infiltration, as confirmed in our study by whole-body MRI. False negative results of the RSS are reported in 30-60% [9,10,[21][22][23]. Vande Berg et al investigated 37 patients with MGUS and reported in 7/39 (19%) focal and diffuse bone marrow alterations [22].…”

Section: Discussionmentioning

confidence: 95%

Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey

et al. 2006

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To compare the diagnostic value of whole-body MRI versus radiological skeletal survey (RSS) in staging patients with plasma cell neoplasms (PCN) and to evaluate the possible therapeutic impact of the replacement of RSS by whole-body MRI. Fifty-four patients with PCN [multiple myeloma (MM), n=47; monoclonal gammopathy of unknown significance (MGUS), n=7] were studied by whole-body MRI and RSS in a monocenter prospective analysis from August 2002 to May 2004. The MRIs were performed using a rolling table platform "AngioSURF" for unlimited field of view with a 1.5-T system (Magnetom Sonata/Maestro Class, Siemens Medical Solutions, Erlangen, Germany). A coronal STIR sequence (TR5500-4230/TE102-94/TI160) was used for imaging of the different body regions, including the head, neck, thorax, abdomen, pelvis and upper and lower extremities. The RSS consisted of eight different projections of the axial and appendicular skeleton. In 41/54 (74%) patients, the results of the whole-body MRI and RSS were concordant. In 11/54 (20%) patients, both imaging techniques were negative. Bone involvement was observed in 30/54 (55%) patients; however, whole-body MRI revealed this more extensively than the RSS in 27/30 (90%) patients with concordant positive imaging findings. In 3/30 (10%) patients, both imaging techniques demonstrated a similar extent of bone marrow infiltration. In 10/54 (19%) patients, the whole-body MRI was superior to RSS in detecting bone marrow infiltration, whereas the RSS was negative. In 3/54 (6%) patients, the RSS was proven to be false positive by the clinical course, whereas the whole-body MRI was truly negative. Whole-body MRI is a fast and highly effective method for staging PCN patients by the use of a rolling table platform. Moreover, it is more sensitive and specific than RSS and reveals bone marrow infiltration and extensive disease more reliably. Therefore, whole-body MRI should be performed as an additional method of exactly staging PCN patients and - with more data in the field - may even prove to be an alternate and more sensitive staging procedure than RSS in PCN patients.

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“…Additionally, radiographs often cannot differentiate between treated skeletal lesions and viable malignancy [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…Total body static 11 C-acetate PET/CT obtained 20 min after intravenous injection of 555 MBq of 11 C-acetate was acquired. 18 F-FDG (740 MBq) was injected intravenously 4 h after 11 C-acetate PET/CT. Sixty minutes after 18 F-FDG injection, total body static PET/CT was performed using the same method as 11 C-acetate PET/CT.…”

Section: Case Reportmentioning

confidence: 99%

Incidental finding of an 11C-acetate PET-positive multiple myeloma

et al. 2009

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Multiple myeloma is a malignancy of plasma cells. The (18)F-FDG PET findings of multiple myeloma have been reported previously. However, the (11)C-acetate PET findings have not been clarified. Here, we report a case of multiple myeloma detected with (11)C-acetate PET in a 51-year-old male patient with known hepatocellular carcinoma. The patient was admitted for management of a pathologic fracture of the right tibia. Imaging workup including X-ray, magnetic resonance image, bone scintigraphy; (18)F-FDG led to a suspicion of metastatic bony lesions. Further, these lesions showed increased uptake on (11)C-acetate PET. Wide excision of the right tibia was performed, and histopathological examination of the lesion confirmed multiple myeloma. This case illustrates the characteristic (11)C-acetate PET findings of multiple myeloma.

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The value of magnetic resonance imaging in screening myeloma lesions of the lumbar spine

Cited by 51 publications

References 10 publications

Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma

Comparison of whole-body 64-slice multidetector computed tomography and conventional radiography in staging of multiple myeloma

Whole-body MRI in the detection of bone marrow infiltration in patients with plasma cell neoplasms in comparison to the radiological skeletal survey

Incidental finding of an 11C-acetate PET-positive multiple myeloma

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